-LRB- CNN -RRB- -- `` These types of patients have such disfigurement beforehand they ca n't eat , they ca n't breathe properly . It 's about functionality , '' says Dr. Richard Luskin , CEO of the New England Organ Bank .

Luskin is referring to the small group of people worldwide who are on waiting lists in hope of a new face , and in the United States at least , they may now have one donated to them more readily .

Last month the United Network of Organ Sharing -LRB- UNOS -RRB- , a non-profit organization managing the U.S. organ transplant system , approved the first national policies for the transplantation of limbs , faces and other structures collectively known as `` vascularized composite allografts '' -LRB- VCAs -RRB- -- which should make it easier to find donors .

As of April 2014 , there had been 28 face transplants across the world . Animal attacks , severe burns and gunshot wounds had left these recipients scarred for life , literally , in the one place their scars can not be hidden -- their face .

`` Anyone with this disfigurement would argue they 're not living , they 're surviving , '' says Luskin .

Face transplant recipients : New findings

A growing field

The first face transplant was performed in France in 2005 on Isabelle Dinoire , whose mouth , nose and chin had been chewed away by her dog . Since then the field has grown and transplants involving varying combinations of facial parts have been performed in six other countries , including the United States .

As the procedures improve and their safety grows , donor registries and collaborating hospitals will increasingly be asking the question : Would you like to donate your face ? Or in the case of the UNOS approval , asking family members of potential donors the sensitive question of whether they will donate the face of their loved one .

The UNOS approval will initially be in place temporarily for 15 months to enable public comment , but families of donors will receive extra guidance when it comes to making the decision . `` Face transplants remain unique and require very specific criteria such as hairlines and ethnic components , '' explains a UNOS spokesperson . `` Therefore consent should be distinct and individual . ''

'' -LRB- This -RRB- will broaden the donor pool for wait-listed patients across a number of regional and national organ procurement organizations , '' explains Dr. Eduardo Rodriguez , professor of reconstructive plastic surgery at NYU Langone Medical Center . `` A major component for a successful procedure is patient selection on both the recipient and donor , '' he adds . `` The likeliness of a perfect match can be very challenging . ''

But this once-experimental procedure is becoming more widespread and accepted . Richard Norris , from Virginia , received a new face in March 2012 and last month his face was featured on the cover of the U.S. edition of men 's magazine GQ . Norris lost most of his facial features after a gun blast , and lost abilities such as his sense of smell . But after surgery at the hands of Rodriguez and his team he can live his life once again .

Face transplant patients : Where are they now ?

Risk of rejection

However , as this mode of surgery becomes a norm , the side effects and risks that come with the life-changing operation are still a concern and a question of ethics .

Like any other transplant , there is a risk of the new organ being rejected by the patient 's immune system and recipients have to take immunosuppressive drugs for the rest of their lives , putting them at risk of infections and cancer . But unlike many other transplants , replacing a face is not a matter of life and death . The surgery is classed by some as life-changing , not life-saving , which raises questions as to whether this risk is justified .

`` For heart transplant patients they need a transplant or they will die . These -LRB- face transplant -RRB- patients are not in organ failure but are having to take anti-rejection medication and have lifelong repression , '' explains Dr. Maria Siemionow , from the University of Illinois , who performed a near-total face transplant in 2008 on American Connie Culp , who was shot in the face by her husband .

But Siemionow is working to solve this problem . `` We need new therapies which will be less harmful , '' she says .

The Polish surgeon is developing chimeric cells , which bring together the cells from a donor and the recipient during transplantation . `` We are fusing together cells from the bone marrow of donors and recipients so these cells will be recognized by the recipient 's immune systems as their own , '' she explains . Not an easy task .

By combining the two cells and delivering them into patients receiving a transplant , their immune system will learn to recognize the donor 's cells , which are present throughout their new face , making their immune cells less likely to attack the face .

`` If the -LRB- immune system -RRB- can recognize more cells as ` self ' the patient will need less anti-rejection drugs , '' says Siemionow , whose experimental therapy is hoped to enter clinical trials in a few years and when it does , may make face transplants more acceptable to critics .

`` Immunosupression is the main ethical concern and new therapies are crucial for the future of this field , '' she says .

Luskin feels the benefits of a new face counter ethical doubts . `` There is no ethical issue , '' he concludes . `` I saw a patient walking down a crowded hospital hall a few years after surgery and no-one noticed them . He looked like a normal guy . To me , that 's the point of these surgeries . ''

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The first face transplant was performed in France in 2005

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U.S. has approved policies that will make it easier to find donors

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Scientists are developing techniques that will reduce risk of transplant rejection